Surgery or palliation for hip fractures in patients with advanced malignancy?
OBJECTIVE
to investigate the management and outcome of patients with advanced cancer who sustain fractures of the neck of femur.


METHODS
multi-centre, prospective, observational study.


METHODS
patients with advanced malignancy, under the care of a palliative care team, who subsequently fractured a femur.


METHODS
survival time post-fracture, return home.


RESULTS
40 patients were recruited with a fractured neck of femur. Analysis of the management of patients according to the Eastern Co-operative Oncology Group performance score was undertaken. Twenty-nine patients were treated surgically and 11 conservatively. For patients with performance scores of 0, 1 and 2 surgery usually resulted in a successful rehabilitation outcome and discharge. None of those with scores of 3 or 4 returned home.


CONCLUSIONS
patients with advanced malignancy and a poor performance score should not be automatically referred for surgery.
McNamara
P
P
Princess Alice Hospice, Esher, Surrey, UK.
Sharma
K
K
D000368:Aged; D005265:Femoral Neck Fractures / Q000601:surgery* / Q000628:therapy; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D010166:Palliative Care; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome